Provider Demographics
NPI:1386422871
Name:CLARK, CAITLIN MARIE (LSW)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
Last Name:CLARK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 US HIGHWAY 202 N
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3791
Mailing Address - Country:US
Mailing Address - Phone:908-458-6206
Mailing Address - Fax:
Practice Address - Street 1:953 US HIGHWAY 202 N
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3791
Practice Address - Country:US
Practice Address - Phone:908-458-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker